01616nas a2200169   4500000000100000008004100001260001000042653002100052100001800073700001300091245012600104856009800230300001200328490000700340520108500347022001401432       2021                            d  bLepra10aGeneral Medicine1 aGovindasamy K1 aPaul SKM00aAppropriate footwear and orthoses are essential components in the management of the foot at risk of ulceration in leprosy  uhttps://leprosyreview.org/admin/public/api/lepra/website/getDownload/61b86978afaac15d720cd04c  a366-3740 v923 a<p>Ulcers are a serious complication and a common cause of morbidity in leprosy. The exact roles of impairments and distorted mechanics of the foot are not fully understood in the development of ulcers in patients with anaesthetic feet. A simple biomechanical evaluation of the foot along with the routine neurological assessment helps to identify feet at risk for developing an ulcer and also to prescribe appropriate orthoses, which are inserts designed to improve biomechanical function, encourage proper joint alignment and protect the foot. The orthotic intervention along with protective footwear offloads the peak plantar pressure sites of the foot, preventing ulceration. The provision and use of foot orthoses have generally been limited to tertiary leprosy referral centres. Advances in technology have made the fabrication of orthoses more rapid and precise, enhancing user acceptance and adherence. Effort should be made to provide simple orthoses that are easy to fabricate and effective in preventing plantar ulcers in leprosy, in the community health setting.</p>
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